#6696 COGNITIVE IMPAIRMENT IN PATIENTS ON HEMODIALYSIS EXPERIENCE FROM A CENTER IN SANTA ROSA GUATEMALA
Notice bibliographique
Résumé
Abstract Background and Aims Cognitive impairment in patients with chronic kidney disease (CKD) involves multiple factors such as inflammation, uremic toxins and endothelial dysfunction, having rates of up to 10.7 cases per 1000/patient year and that can increase in renal replacement therapy (RRT). The cognitive impairment can progress to dementia and this has adverse long-term outcomes such as mortality. The prevalence of cognitive impairment is 19% to 77% in patients with hemodialysis therapy. The aims of this study was determine the prevalence of cognitive impairment in hemodialysis patients and possible associated factors. Method A cohort study was conducted in a hemodialysis unit of Santa Rosa, Guatemala. Patients over 18 years of age were included with more than two months of having started hemodialysis and with 3 sessions per week. Patients with a previous diagnosis of dementia, with visual-hearing deficits, illiterate, a history of cerebrovascular events or psychiatric disorders and who did not agree to participate in the study were excluded. For cognitive assessment, the Montreal Cognitive Assessment tool (MoCA test) was used, taking a score of less or equal than 26 points as cognitive impairment. A value of p<0.05 was taked significant. Results 78 patients were screened, however 30 patients were discarded due to exclusion criteria. A total of 48 patients were analyzed. A mean age was of 51 years, the majority of whom were male, 40% had only a basic level of education and 38% did not know the cause of CKD. Arterial hypertension was the most frequent comorbidity and the most used antihypertensive were beta-blockers. As for medications for complications of CKD, vitamin D and erythropoietin are the most used. The patients had an average time on hemodialysis of 41.3 months, the last calculated Kt/V was of 1.73 (mean), the mean hemoglobin level was 9.9 g /dl and the mean MoCA test score performed for the study was 23.3 points. Regarding the primary objective, it was determined that the prevalence of cognitive impairment was 67% and when analyzing the variables it was found that age and level of education are associated with greater cognitive impairment, older patients (p: 0.002) and with lower level of education (p: 0.02). In analysis the cognitive domains, it is founded that those patients who present alterations in the attention and delayed recall domain are those that are statistically more associated with cognitive impairment and their counterpart those who have conserved the naming and language domain are those that are associated with having a normal global cognitive practice (Table 1). A correlation analysis was performed where it was found that there is a negative correlation which is moderate and statistically significant between age and the MoCA test score (Table 2). Conclusion The prevalence of cognitive impairment was 67%, age and educational level seem to be influencing factors, with older patients and those with lower educational level being the most affected. Within the cognitive domains, attention and delayed recall are the most affected and most associated with cognitive impairment. It is important to conduct further studies evaluating other variables that have been shown to influence cognitive status such as vitamin B12, vitamin D and homocysteine. It is important to perform cognitive evaluation of patients on hemodialysis and other RRT to have an early diagnosis and intervene early considering that cognitive impairment can progress to dementia and this is a cause of abandonment in treatment and mortality.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».